Using virtual reality to treat PTSD

Mark Pollack, chair of the psychiatry department at Rush University Medical Center (on the left), tests the virtual reality software used to treat patients with PTSD.

In a small windowless office at Rush University Medical Center, Charles Small hooks up what looks like a video game console. It's got three screens, a headset and a carpeted platform. Nearby is a trough of vials: the odors of burning rubber, diesel exhaust, cordite, which is the smell of weapons fire.

Small flips a switch and the screens light up. They show the interior of a Humvee traveling through a village in Iraq. The viewer seems to be inside as the vehicle lurches down a potholed road. Suddenly, there's a rumble, and the carpeted platform trembles. Small shuts off the machine.

Small is a licensed clinical social worker at Rush's Road Home Program, which treats veterans and their families for emotional and psychological issues. He's demonstrating a virtual reality machine, a $40,000 setup used to treat veterans whose post-traumatic stress disorder “is shrinking their worlds,” Small says. A bump in the road, a sound or even a roadside pile of trash can trigger debilitating fear. “These guys won't drive to the grocery store,” he says.

Virtual reality, he explains, exposes veterans to the sights, sounds, sensations and even scents of the events responsible for their trauma: a shooting, an attack, an IED explosion. Exposure to the trauma in a safe, controlled setting can help retrain brains to overcome fear. “It's a really challenging thing to do,” Small says. “It's not for everyone.”

Virtual reality is just one of the unique ways in which Road Home treats veterans and their families. Another innovation is the Intensive Outpatient Program, in which veterans spend three weeks on the Rush campus receiving group and individual therapy as well as wellness, nutrition and resiliency training. A recent IOP focused on sexual trauma, which happens to an estimated 1 in 5 servicewomen.

Photo

Manuel Martinez

Virtual reality can recreate the sights, sounds and even the scents of the events responsible for a combat veteran's trauma.

The program itself is unique, one of only a dozen around the country that treat the family unit. That holistic approach is crucial, experts say, as the suicide risk for veterans climbs once they return home. About 2.4 million American men and women have served in Iraq and Afghanistan since 2001; every day, 22 veterans commit suicide.

“We are doing precious little to help our servicemen and women readjust after the trauma of war,” says Susan Crown, founder and chairman of private investment firm Owl Creek Partners and a Rush trustee. “I think (Road Home is) an important and, frankly, appreciative thing to do.”

Road Home was launched in March 2014 with $1 million from Welcome Back Veterans—an initiative of the McCormick Foundation and Major League Baseball—and the backing of Rush's board. Crown co-chaired Road Home's inaugural fundraising dinner, which was held in June and grossed $1.4 million.

In two years, the program has treated about 420 veterans and family members. Its fiscal 2017 operating budget is $6.6 million. In 2015, it received funding from Orlando, Fla.-based Wounded Warrior Project, which pledged to grant $5 million for the following three years, provided Rush could raise $2.5 million in each of those years. So far, it has.

The cost of treatment per veteran: about $10,000, more for more complex cases. Road Home underwrites 98 percent of treatment costs for veterans and their families.

Alexis and Luis Gilbert have been clients of Road Home for a year. Luis, 27, suffered a traumatic brain injury while serving in the Marine Corps and has PTSD. He returned home with psychological issues, including memory loss, that prevent him from working.

“The future we wanted to build together isn't really a possibility now,” says Alexis, 26, who lives in Lisle with Luis and their three small children. Her husband's injuries “have affected every area of my life, the kind of wife and mother I thought I would be.”

The couple's experience at Road Home “just clicked,” she says. “From the moment we walked in the door, they held my hand and reassured (Luis) and me.” Staff suggested small steps to help Luis with his memory problems—for instance, remembering to keep his cellphone with him every day for a month.

“The future we wanted to build together isn’t really a possibility now. (Luis’ injuries) have affected every area of my life, the kind of wife and mother I thought I would be.”

Alexis Gilbert, whose husband, Luis, is in the Road Home Program

Army veteran Eric Chessier underwent treatment at Road Home for six months last year. “I went in with guilt, anger and bitterness, and came out much more optimistic and patting myself on the back, 'Hey guy, you did OK,' ” says Chessier, 46, a regional safety facilitator at Chicago Public Schools.

Chessier now has a better relationship with his second wife and their two children, as well as the grown children from his first marriage. The treatment “let me be more hands-on and giving with my kids,” he says.

Road Home's founder and director is Dr. Mark Pollack, chair of the psychiatry department at Rush University Medical Center. Pollack's brother, Lt. Col. Don Pollack, a career Army attorney, helped spark his interest in treating veterans. Don Pollack had been stationed in Baghdad, setting up a judicial system in 2004 and 2005, and told his brother about watching soldiers leave the base every day. “He knew that two or three weren't coming back,” says Mark Pollack, 58. “They weren't coming back in one piece, or they weren't coming back at all.”

In addition to running the program and helping with fundraising, Pollack sees patients, one or two a month. One example: a veteran who, while on patrol in a small village in Iraq, killed an 8-year-old would-be suicide bomber. The soldier saved the lives of fellow soldiers and of citizens in the village. “But he's been tortured with that image,” Pollack says.

In 2007, Pollack, who for almost 30 years was director of the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital, co-launched a veterans care program sponsored in part by the Boston Red Sox. That program, Home Base, also treated veterans' families.

In 2011, Pollack was recruited to head the psychiatry department at Rush. He and his wife, psychiatrist Patricia Normand, were looking for a change, and it helped that Rush planned to launch a program similar to Home Base.

Photo

Manuel Martinez

Road Home's founder and director is Dr. Mark Pollack, chair of the psychiatry department at Rush University Medical Center.

Through his experience with Home Base, Pollack learned that a program needs the trust of veterans to succeed. To build that trust among Chicago's 75,000 veterans, he hired as executive director William Beiersdorf, himself a veteran, who founded Salute, a nonprofit that helps military families avoid homelessness.

Rush asked veterans what they wanted in a treatment program. “They told us: 'We don't want to see white coats. We don't want to feel like we're going to a doctor's office where the perception is we're sick,' ” says Beiersdorf, 52. In response, Road Home is in an office building, not a hospital, and clinicians walking the quiet hallways wear business-casual clothes.

Road Home plans to ramp up to serve 500 people a year, plus consolidate operations at Rush's Westgate building, in which it leases space from the university. Also on the to-do list: ensuring that veterans and families get follow-up care and support. About 90 percent of patients live within driving distance of Rush, and the remainder come from outside the state. “Sometimes they don't have the resources” to get follow-up care, Beiersdorf says, adding that he expects more clients to come from a wider area as Road Home expands.

Telehealth—treating via Skype, phone and other tools—would help tremendously, especially for patients who live outside Illinois. Road Home is working on licensing several counselors in Indiana and Wisconsin so they can treat veterans there without running afoul of licensing rules, which require counselors to treat patients only in the state in which they're licensed.

Meanwhile, Road Home has a formidable, if not precarious, track record. Asked if the program has lost a patient to suicide, Pollack hesitates, and the silence is heavy. “Thankfully, not yet,” he says. “I almost hesitate to say it—I don't want to jinx it—but we work hard to make ourselves available, to be there, to give people resources.”

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